What do people search online about sciatica? What answers do they get from Dr. Google? A mixed analysis of Italian web-based data.

Introduction: Spine-related leg pain (SRLP), also commonly referred to as sciatica, is characterized by many unanswered questions. Nowadays, patients search for information online to find answers not provided by clinicians. Therefore, this work aimed to (i) collect the main questions and keywords searched by the Italian general population related to SRLP, (ii) analyze the content of the most clicked web pages, (iii) investigate its alignment with evidence-based recommendations, and (iv) assess their credibility and (v) readability. Methods: SEMrush was used to collect questions, keywords, search volumes, and web pages. Credibility was assessed through the QUality Evaluation Scoring Tool (QUEST). Readability was evaluated by the Gulpease index. Thematic and content analyses were performed. Results: Monthly search volumes ranged from 4,400 to 33,100. QUEST scores ranged from 1 to 14 out of 28. Readability scores ranged from 20 to 47 out of 100. Common themes highlighted the roles of medications and physiotherapy, the value of doing effortless activities, and the importance of sleep. Content analysis showed that 11 codes (41%) were aligned with, 7 (26%) were contradicted by, and 26 (96%) were entirely omitted from at least one web page. Conclusion: The findings suggest that inaccurate, poorly credible, and difficult-to-read information on SRLP are common online, leading to plausible targets for the educational intervention of clinicians dealing with SRLP patients. Clinicians are now more aware of the questions that their patients could be asking to Google and the answers it provides about SRLP.